{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T18:07:59Z","timestamp":1779127679313,"version":"3.51.4"},"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Persistent pulmonary sequelae after SARS-CoV-2 infection remain a concern in workers exposed to environmental and physiological stressors such as intermittent high-altitude hypoxia. Few studies include pre-pandemic spirometry or focus on this occupational group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional study was conducted in 400 sea-level-born workers intermittently exposed to altitudes &gt;2500 m, all with confirmed COVID-19. Only A\/B-quality spirometry from 2024 was included. Sociodemographic, clinical, and occupational variables were assessed, and adjusted prevalence ratios (aPR) were estimated using Poisson regression with robust variance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 72.2% of workers showed spirometric abnormalities (40.5% mixed, 20.8% restrictive, 11.0% obstructive). Independent predictors included obesity (aPR 1.35; 95% CI 1.19\u20131.53), higher Charlson index (aPR 1.49; 95% CI 1.33\u20131.68),\u2009\u2265\u20095 years of inhalant exposure (aPR 1.64; 95% CI 1.43\u20131.89),\u2009\u2265\u20097 years of intermittent high-altitude exposure (aPR 1.81; 95% CI 1.60\u20132.05), and severe COVID-19 (aPR 1.65; 95% CI 1.41\u20131.91).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Over 70% of participants showed abnormal spirometry was found in post-COVID-19 workers with intermittent high-altitude exposure. Respiratory function monitoring should be reinforced in this occupational group, especially among those with higher clinical and environmental risk factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0329054","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T17:30:02Z","timestamp":1779125402000},"page":"e0329054","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Post-COVID spirometric abnormalities in workers with intermittent high-altitude exposure: A cross-sectional study in Peru"],"prefix":"10.1371","volume":"21","author":[{"given":"Jair Alonso","family":"G\u00f3ngora-Bendez\u00fa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marleyssi Valeria","family":"Martinez-L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angel 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